Marie Neba, co-owner of Fiango Home Healthcare Inc., a Houston, Texas area home health agency, was convicted by a south Texas jury on November 10, 2016 of multiple federal health care fraud crimes involving an illegal scheme of paying kickbacks to patient recruiters and physicians in return for home health patient referrals.

According to the evidence presented at trial, Neba along with her co-owner and husband Ebong Tilong and others conspired to defraud Medicare by submitting over $13 million in false and fraudulent claims for home-health services to Medicare. To accomplish this conspiracy, Neba and Tilong paid illegal kickbacks to physicians in exchange for authorizing medically unnecessary home-health services for Medicare beneficiaries. Using the money that Medicare paid for such fraudulent claims, Neba and Tilong paid illegal kickbacks to patient recruiters for referring Medicare beneficiaries for home-health services. Neba and Tilong also paid illegal kickbacks to Medicare beneficiaries for allowing them to bill Medicare using their Medicare information for home-health services that were not medically necessary or not provided. Further, the evidence showed that Neba and Tilong falsified medical records to make it appear as though the Medicare beneficiaries qualified for and received home-health services.

The Criminal Division’s Fraud Section, which prosecuted the case, leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 2,900 defendants who have collectively billed the Medicare program for more than $10 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

The cases against Neba and her co-conspirators are criminal cases. However, under the qui tam provisions of the False Claims Act, whistleblowers with information about similar fraud against the government may bring a civil case on behalf of the United States. If successful, the government can recover three times the amount the defendants fraudulently billed the government and monetary penalties for each false claim. The whistleblower, who originally filed the case, is entitled to 15-30% of the government’s recovery as well as their attorney’s fees.